Impact of Social Isolation and Loneliness on Cognition and Psychological Well-being: An Intervention Study among Residents of Indian Old Age Homes

Abstract

The population dynamics in India have been undergoing significant transformations characterized by reduced fertility and mortality rates, thereby resulting in an increased proportion of the aged population (60 years and above). Among multiple concerns associated with the process of ageing, increased levels of social isolation and loneliness are important concerns. The prevalence of social isolation and loneliness among older adults, and their co-existence is understudied in India. Further, the impact of social isolation and loneliness on the cognitive functioning and psychological well-being of older adults residing in old age homes is less explored in the Indian context. The study assesses the prevalence of social isolation and loneliness among the residents of old age homes. The study further examines the impact of social isolation and loneliness on the psychological well-being and cognitive functioning of older adults. Moreover, it explores the mediating impact of psychological well-being on the association of social isolation, loneliness, and cognitive functioning in older adults. Further, the efficacy of leisure-based intervention aimed to reduce social isolation, loneliness, enhance psychological well-being, and prevent faster cognitive decline among the older adults has been assessed. The study has been conducted in two phases. In the first phase, data has been collected from the residents of various old age homes of Odisha. The participants have been selected using purposive sampling, and 320 older adults aged 60 years or above participated in the study. Standardized measures like Lubben Social Network Scale-6 (LSNS-6), Revised UCLA Loneliness Scale, Ryff’s Psychological Well-Being Scale, and Hindi Mental State Examination (HMSE) have been used for data collection. After the analysis of pretest scores from the first phase, sixty participants categorised based on their social isolation and loneliness scores have been purposively selected for the second phase; and thereafter randomly assigned for the administration of leisure-based intervention framework. Further, various statistical methods like t-tests, multivariate analysis of variance, linear regression, mediation analysis, and bootstrapping have been employed for data analysis. The results reveal a high prevalence of social isolation (84.38%) and loneliness (86.88%) among the residents of old age homes. Further, a statistically significant MANOVA effect has been obtained for social isolation (F=3.836, p<.01), and loneliness (F=3.782, p<.01) on psychological well-being, suggesting the significant impact of reduced social interactions on the psychological well-being among older adults. Moreover, a significant regression equation was obtained (F=19.28, p<.01), with an R2 of 0.154, suggesting that loneliness significantly impacted the cognitive functioning of older adults. Furthermore, in bootstrapped samples (n=1000), loneliness predicted approximately ten percent of the variance in explaining cognitive health. Additionally, both social isolation (z= -4.71**) and loneliness (z= 4.03**) exhibited significant indirect effects on cognitive functioning of the participants with psychological well-being as a mediating factor. Additionally, leisure-based intervention has been proved effective across all experimental groups of participants in mitigating social isolation and loneliness, and enhancing psychological well-being and cognition among the participants. The findings of the study can be incorporated into measures aiming at alleviating feelings of social isolation and loneliness, improving their psychological well-being, and preventing faster cognitive decline among older adults. The intervention framework can be adapted for the residents of various old age homes to help them have a fulfilling senescence.